BACKGROUND: Although there are improvements of clinical symtoms after bronchodilator inhalation in COPD patients, it has been noted that there was no increase of FEV1 in some cases. FEV1 did not reflect precisely the improvement of ventilatory mechanics after bronchodilator inhalation in these COPD patients. The main pathophysiology of COPD is obstruction of airway in expiratory phase but in result, the load of respiratory system is increased in inspiratory phase. Therefore the improvement of clinical symptoms after bronchodilator inhalation may be due to the decrease of inspiratory load. So we performed the study which investigated the effect of bronchodilator on inspiratory response of vetilatory mechanics in COPD patients. METHODS: In 17 stable COPD patients, inspiratory and expiratory forced flow-volume curves were measured respectively before bronchodilator inhalation. l0mg of salbutamol solution was inhaled via jet nebulizer for 4 minutes. Forced expiratory and inspiratory flow-volume curves were measured again 15 minutes after bronchodilator inhalation. RESULTS: FEV1, FVC and FEV1/FVC% were 0.92 +/-0.34L(38.3+/- 14.9% predicted), 2.5+/-0.81L (71.1 +/-21.0% predicted) and 43.1+/-14.5% respectively before bronchodilator inhalation. The values of increase of FEV1, FVC and PIF(Peak Inspiratory Flow) were 0.15 +/-0.13L(relative increase: 17.0%), 0.58+/-0.38 L(29.0%) and 1.0+/-0.56L/sec(37.5%) respectively after bronchodilator inhalation. The increase of PIF was twice more than FEV1 in average(p<0.001). The increase of PIF in these patients whose FEV1 was not increased after bronchodilator inhalation were 35.0%, 44.0% and 55.5% respectively. CONCLUSION: The inspiratory parameter reflected improvement of ventilatory mechanics by inhaled bronchodilater better than expiratory parameters in COPD patients.
Albuterol ; Humans ; Inhalation ; Mechanics ; Nebulizers and Vaporizers ; Pulmonary Disease, Chronic Obstructive* ; Respiratory System

As the sciences advanced rapidly in the modern European world, outstanding achievements have been made in medicine, chemistry, biology, physiology, physics and others, which have been co-influencing each of the scientific disciplines. Accordingly, such medical and scientific phenomena began to be reflected in novels. In particular, Mary Shelley's Frankenstein includes the diverse aspects of the change and development in the medicine and science. Associated with medical and scientific information reflected in Frankenstein and Frankenstein's experiments in the text, accordingly, this research will investigate the aspects of medical and scientific development taking place in the nineteenth century in three ways. First, the medical and scientific development of the nineteenth century has been reviewed by summerizing both the information of alchemy in which Frankenstein shows his interest and the new science in general that M. Waldman introduces in the text. Second, the actual features of medical and scientific development have been examined through some examples of the experimental methods that M. Waldman implicitly uttered to Frankenstein. Third, it has been checked how the medical and scientific development is related to the main issues of mechanism and vitalism which can be explained as principles of life. Even though this research deals with the developmental process of medicine & science and origin & principles of life implied in Mary Shelley's Frankenstein, its significance is that it is the interdisciplinary research focussing on how deeply medical and scientific discourse of Mary Shelley's period has been imbedded in the nineteenth century novel.
Biomedical Research/*history ; History, 19th Century ; Literature, Modern/*history ; *Medicine in Literature

This study was conducted to measure the lead level in the blood, scalp hair and toenail of the elementary schoolchildren and assess the relationship among those samples. Lead concentration of the blood, scalp hair and toenail was measured for l00(male 50, female 50) fourth grade elementary schoolchildren in Taegu city. The mean lead level in the blood, scalp hair and toenail was 6.00+/-2.44 microgram/dl, 6.28+/-3.54 microgram/dl 6. 68 and 7.33+/-3.18 microgram/g. The mean lead level in the blood of schoolboys was 6.43+/-2.77 microgram/dl and that of schoolgirls was 5.59+/-2.01 microgram/dl. The mean lead level in the scalp hair of schoolboys was 7.66+/-2.97 microgram/dl and that of schoolgirls was 6.88+/-3.54 microgram/g. The mean lead level in the toenail of schoolboys was 8.19+/-3.5 microgram/g and that of schoolgirls was 6.47+/-2.52 microgram/g and their difference was statistically significant. In schoolboys, the correlation coefficient between the lead level in the blood and scalp hair was 0.4909, and the data were fitted best by the regression equation Y=0.5255X+4.2810, where Y and X are scalp hair and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and scalp hair was 0.3778, and the data were fitted best by the regression equation Y=0.6655X+2.9632, where Y and X are scalp hair and blood concentration. In schoolboys. the correlation coefficient between the lead level in the blood and in the toenail was 0.5533, and the data were fitted best by the regression equation Y=0.7076X+3.6472, where Y and X are toenail and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and in the toenail was 0.2738, and the data were fitted best by the regression equation Y=0.3431X+4.5570 where Y and X are toenail and blood concentration. In schoolboys, the correlation coefficient between the lead level in the scalp hair and in the toenail, in the schoolboys was 0.4148, and the data were fitted best by the regression equation Y=0.4956X+4.3986, where Y and X are toenail and scalp hair concentration. In schoolgirls the correlation coefficient between the lead level in the scalp hair and in the toenail 0.1159, and the data were fitted best by the regression equation Y=0.0825X+5.9214 here Y and X are toenail and scalp hair concentration. Correlation among lead concentration in the blood, scalp hair and toenail of schoolchildren were statistically significant except between scalp hair and toenail in schoolgirls. These finding suggest that blood, scalp hair and toenail can be used substitutive samples between each others.
Daegu ; Female ; Hair* ; Humans ; Nails* ; Scalp*

No abstract available.
Crohn Disease*

MR imaging was performed in 40 patients of aortic disease from March 1988 to February 1990. Transverse, coronal and oblique sagital views were obtained with ECG gating and even echo technique using 0.5 T and 2.0 T MR systems. In 12 patients of aortic aneurysm, the location, the size and the extent of aneurysm could be assessed in all cases. In the cases of six abdominal aortic aneurysm, the relation of aneurysm to renal arteries was evaluated. In 18 cases of aortic dissection, the extent of involvement as well as associated abnormalities was well evaluated in all cases. In the 8 cases of congenital aortic anomalies, the vascular anatomy was well demonstrated. However, the abnormalities of major branches could not be assessed with MR imaging especially in 2 cases of Takayasu's arteritis. With our experiences, MR imaging is regarded as a primary diagnostic modality for aortic disease and expected to be developed as the alternative measure to the angiography in the future.
Aneurysm ; Angiography ; Aorta ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Aortic Diseases* ; Electrocardiography ; Humans ; Magnetic Resonance Imaging* ; Renal Artery ; Takayasu Arteritis

STUDY DESIGN: A retrospective study was performed in 22 cases undergoing anterior screw fixation for type II odontoid process fracture. OBJECTIVES: To determine the utility of anterior screw fixation for type II odontoid process fracture and assess the influence of several factors including the number of screw on results. SUMMARY OF BACKGROUND DATA: There are few data on the surgical results of type II odontoid process fracture in Korea. MATERIALS AND METHODS: Between Jan. 1987 and Jan. 1997, 24 patients were operated by anterior screw fixation for the type II odontoid process fracture, but 2 patients were lost to follow-up and we analyzed 22 patients with average 68 month followup(range: 24~142 months). Nine patients were operated by anterior fusion using one screw(group I) and 13 patients using two screws(group II). There were 19 fresh odontoid fractures, 3 delayed union preoperatively. The amount of correction of initial displacement and angulation, bone union and perioperative complications were selected as assessment criteria. Eric and James' functional outcome scale was used for the functional results. The statistical analysis using the two-way ANOVA and chisquare test was performed. RESULTS: In clinical results, excellent functional outcome were obtained in 6 cases of group I and 10 cases of group II, while good functional outcome in 3 cases of group I and 3 cases of group II according to Erric and James' criteria(p=0.477). There was no case with fair or poor results in both groups including nonunited case. In radiological results, union rate was 86.4%(19 patients) totally, 67%(6 patients) in group I and 100%(13 patients) in group II retrospectively(p=0.045). The mean time to fusion was 11.3 weeks in all cases and there was no difference between both groups(p=0.521). In all cases, reduction rate was 4.0mm(displacement in lateral view), 1 . 5degree(angulation in lateral view), 1.5degree(angulation in open mouth view) postoperatively, being 5.7mm, 2.5degree, 2.8degreein group I and 3.6mm, 3 . 8degree, 0.6degreein group II. There was no significant differences between both groups(p=0.164, p=0.794, p=0.235). SUMMARY: Anterior screw fixation was clinically and radiologically reliable surgical treatment option for type II odontoid process fracture. Speaking of the number of screw used in anterior screw fixation, two screw group showed better results in union rate.
Humans ; Korea ; Lost to Follow-Up ; Mouth ; Odontoid Process ; Retrospective Studies

In hypertensive patients it is very important to detect renal artery stenosis or pheochromocytoma, since both diseases are curable causes of hypertension. However, renal artery stenosis can be induced by pheochromocytoma, when the diagnosis of the two simultaneous disease is very difficult. We experienced two cases of pheochromocytoma presented as renal artery stenosis. Pheochromcytoma was overlooked when renovascular hypertension was diagnosed. Pheochromocytoma was found during surgery in one patient and after angioplasty in the other. In both cases, BP returned to normal after surgical removal of pheochromocytoma without repair of the stenosis. Prevention of ineffective and unnecessary renal artery angioplasty of surgery requires knowledge of this unusal association between pheochromocytoma and renal artery stenosis and a high degree of clinical alertness for pheochromocytoma.
Angioplasty ; Constriction, Pathologic ; Diagnosis ; Humans ; Hypertension ; Hypertension, Renovascular ; Pheochromocytoma* ; Renal Artery Obstruction* ; Renal Artery*

PURPOSE: To assess the effectiveness and safety of heterograft spacer (Lubboc) as a substitute for autograft in cervical laminoplasty. MATERIALS AND METHODS: 21 patients with cervical myelopathy were treated by spinous process splitting laminoplasty using heterograft intraspinous spacers. The clinical and the radiographic evaluations were checked pre- and postoperatively. RESULTS: The average JOA score was increased from 8.7 preoperatively to 12.9 at the final follow-up with a average recovery rate of 60.6%. Preoperative spinal canal diameter, 14.7 +/- 1.4 mm were improved to 20.1 +/- 1.8 mm postoperatively and canal to body ratio, 0.75 +/- 0.10 to 1.02 +/- 0.11 in average. The intraspinous spacer, heterograft demonstrated fragmentation and partial resorption mainly at the level of C3, 4, 5 from postoperative 2 months, but showed no clinical deterioration in spite of radiographic changes of heterograft. CONCLUSION: We think that heterograft spacer is one of the safe and effective substitutes for autograft in maintaining the improved postoperative radiographic indeces.
Autografts ; Follow-Up Studies ; Heterografts* ; Humans ; Spinal Canal ; Spinal Cord Diseases

PURPOSE: To report the clinical outcomes of deep anterior lamellar keratoplasty (DALK) when sterile gamma-irradiated acellular corneal tissues (VisionGraft) are used in combination with amniotic membrane transplantation (AMT) for intractable ocular surface diseases. METHODS: The medical records of fifteen patients who had DALK with AMT were retrospectively reviewed. Indications for surgery included ocular burn, bacterial keratitis, herpes simplex virus keratitis, corneal opacity with Stevens-Johnson syndrome, Mooren's ulcer, idiopathic myxoid degeneration of corneal stroma, and recurrent band keratopathy. DALK was performed using partial-thickness acellular corneal tissue and a temporary amniotic membrane patch was added at the end of the operation. RESULTS: All cases that underwent DALK with AMT became epithelialized within 2 postoperative weeks. Twelve patients showed favorable outcomes without graft rejection, corneal opacification, or neovascularization. The other three grafts developed corneal opacification and neovascularization, and required additional penetrating keratoplasty (PK). Unlike the results of previous PKs, there were no graft rejections and the graft clarity was well-maintained in these three cases for at least 8 months after PK. CONCLUSIONS: DALK using sterile acellular corneal tissues in combination with AMT may be a good therapeutic strategy for treating intractable ocular surface diseases because of lowered immune rejection, fibroblast activation, and facilitation of epithelialization. Furthermore, DALK can help stabilize the ocular surface, prolong graft survival, and may allow better outcomes when combined with subsequent PK.
Adult ; Aged ; Amnion/*transplantation ; Corneal Diseases/pathology/*surgery ; Corneal Stroma/radiation effects/*transplantation ; Female ; Graft Survival ; Humans ; Keratoplasty, Penetrating/*methods ; Male ; Middle Aged ; Retrospective Studies ; Visual Acuity ; Young Adult

Purpose: We report a case of aqueous misdirection syndrome triggered by pilocarpine use after laser iridotomy, which was treated by pars plana vitrectomy and phacoemulsification.Case summary: A 48-year-old female patient presented with sudden-onset right eye pain and decreased vision. The patient had presented to another institute with similar symptoms 20 days prior; she had been diagnosed with acute angle closure. Laser iridotomy was performed, followed by administration of pilocarpine twice daily. In the right eye, visual acuity was hand motion, and intraocular pressure was 31 mmHg. The laser iridotomy site was located at the 11 o’clock position; microcysts, anterior chamber cells, corneal endothelium precipitates, and glaukomflecken were observed. The anterior chamber was shallow due to forward movement of the lens and iris. Despite the application of atropine and pressure-lowering eyedrops, anterior chamber shallowing continued along with a progressive myopic shift of -4.5 diopters. Therefore, the patient was diagnosed with aqueous misdirection syndrome. Pars plana vitrectomy was performed, followed by phacoemulsification, intraocular lens insertion, and posterior capsulotomy. During surgery, vitreous inflammation, a peripheral snowball, and an anterior hyaloid inflammatory membrane were observed, indicating the presence of intermediate uveitis. Conclusions The administration of miotics after laser iridotomy, intraocular inflammation, and uveitis can lead to aqueous misdirection syndrome. Effective treatment of aqueous misdirection syndrome involves controlling inflammation and performing surgery.